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FOR �Ds . s• mt.. �:.r rt � e�'. �' .4 s 'p7. s4 ``. 1,!FT':Y ='' NON-F AZARDQUJ�MANIFEST 4ADR YY �` 7` _a '' IVOIV"�{,4ZARDOUS�llVi48•f!~WNIFEST ,x b1 C O R P D R A T E d ,"+� ATE TREATMENT AND DISPOSAL FACILITY - WASTE TREATMENT AND DISPOSAL FACILITY !(YCORPORATED _ JOB ACCEPTANCE NO. _ JO_B ACCEPTANCE NO. G ❑GLOVES j❑GOGGLES❑RESPIRA7gR ❑HARD HAT s JAMES M LANGSTON ❑GLOVES ❑GOGGLES❑RESPIRATOR ❑HARD HAT ❑TYVEK ❑OTHER _ CITY-VEX ❑OTHER SPECIAL HANDLING PROCEDURES P 0 BOX 97 SPECIAL HANDLM PROCEDURES LATHROP CA 95330 209-957-5981 Jpl�l REPdRiCK501! WN TYPEt._" is �.L.is�-1 =.a�#:�S�7ifFt REC F a= •3�'1:� " " �_- ❑ SLUDGE ❑ SLUDGE ❑ TREATMENT SOIL ❑NON FRIABLE ASBESTOS FORWARD INC LANDFILL [] TREATMENT SOIL ❑ NON FRIABLE ASBESTOS FORWARD INC LANDFILL D DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD • ❑ DISPOSAL SOIL ❑ WOOD 99$9 SOUTH AUSTIN ROAD ❑ CONSTRUCTION SOIL ❑ ASH ❑CONSTRUCTION SOIL ❑ ASH [ OTHER MANTECA,CALIFORNIA 95336 ; [ OTHER MANTECA,CALIFORNIA 95336 GENERATING FACILITY _ _ _ (209)982-4298 PHONE GENERATING FACILITY (209)982-4298 PHONE Lw"GSTOO'S BAIT 8 TACKLELANGSTOJ'5 9AI8 & T4CYLE 13015 SEVEIITP 5T (209 9) 82-1009 FAX 15x,15 SEVENTH ST (209)982-1009 FAX L4T4Rt7P, CA LAT4ROP, CA NAME - > :_f_�r -e 1 " - _ `,TRUCK NUMBER NAME — NOTES. _ _ _TRUCK NUMBER 4_TC4 HAIILTOr1 TRUCKIrIG y j l n PICH 4A IILT01 TRUC:I 16_ ADDRESS ,_ _ �``�� ADDRESS - " '?r_3!387 91/a 1325 PAULINE AVE LOAD 023 1'39 PAULT_'tE AVE _ LOAD t24 CITY STATE,ZIP •CfTY STATE ZIP "- 1DDESTO, CA 95358 I �2 7 �� 400EST0, CA 95358 PHONE END DUMP 8OTTOM DUMP TRANSFER PHONE END DUMP _ BOTTOM DUMP TRANSFER ''?7-5713-4109 Qx ❑ _ ❑ 2^4-974-1130 u1:10 SIGNMR5 OF AUTHOR¢TD AGENT OR DRIVER DATE POLL-OFF(S) FLAT-BED _�_VAN - DRUMS SIGNATURE OF AORIZED AGENT OR DRIVER DATE _ RO_LLOFF(S)_ -'-FLAT BED VAN DRUMS �F if ❑ ❑ ❑ T ❑ * rtir ❑ © ❑ ❑ cxlalc YARDS ff.'s._ _ CUBIC YAFIDS_,_ FORWARD INC LANDFILL FORWARD INC LANDFILL - Fwward ahae have no oblp Wn to accept the waste d wuther or other Forward Natl hm to ob p Wn to accent rhe warn a weather or other cwmxxn mew the uta and enechro dnoosW at the wase-a rhe wean DISPOSAL METHOa (TO BE GOMPL.ETED BY FORWpRDI conditne etpar the sale era a fecuft dtsocam or the waste or d the wsdt DISPOSAL METHOD, (TO BE COMPLETED BY FORNiARDI we enpaas the ask and attedcmabon iA ar &W w o!the Uw4Forwea whop"the nate erd elfecdw opwahNae us aron of the Lardlal Forward e 810 OTHER nasovde efforts m prarrpty no*Dtaposar of ft eYbBty m accept the ^x'; BIO AERATE — --DTIiER reasombis#Nwu m prnmply roily Draposer of 4s mabd*n accept the _ _ - _ -_ waste far y yuan a Forward a rek"m no"the waste a based on - warn!or arty retrsdr K Forward a refusal m accept rhe wants m bash rhe weather or other erte coed km Forwwd shad nptdy the Dmmw when sde weather or other tae cord;ons Forward DWI rgLfy the Deposer when sae ❑SOL conddghe are expelled tDc wye such that Forward w8 be able m axep ' condd,ons are expected to Charge Such that Forward wre be able to accea the wase ❑ URGE the waste r - r Tyr„ ❑SLUDGE REMARKS �v-. __� .-.K � Y f ❑ a REMARKS NON FR" LE FACLLFTY TICKET NU �'O"" --_ -- " -fr' ASBESTOS FACILITY TX5RET NLFMBER. -- _._, . - �L'•.._ " / �• ❑WOOD ❑WOOD SIGNA RnF��E yrs./'_ ' SIGNTUR&OKAUTHDR! _ _ pjtTE"e ASH ASH /! ❑OTHER il;4OTHER SCHEDULING MUST BE MADE PRIOR TO 4.00 PM THE DAY PRIOR TO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SCHEDULING MUST"EE'MADE PRIOR TO 4-Do PM THE DAY PRIOR TO EXPECTED ARRIVAL•ANY UNSCHEDULED LOADS ARE SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED VATH THE LANDFALL THEDAY BEFORE RE SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE ND THE 54024 n�FORE TO SCHEDULE CALL MANIFEST*(209)982-4298 54023 TO SCHEDULE CALL(209)982-4298 V 4 'm4&jQ nwTKprv%pv